title: Combined ifosfamide, etoposide and oxalipatin chemotherapy, a low-toxicity regimen for first-relapsed or refractory Hodgkin lymphoma after ABVD/EBVP: a prospective monocentre study on 34 patients.
abstract: Around 20% of Hodgkin lymphoma (HL) patients are refractory to first-line therapy with ABVD (adriamycin-bleomycin-vinblastine-dacarbazine) or relapse after complete remission. Salvage regimens frequently have delayed courses or require dose-reduction because of haemotoxicity. We evaluated the IVOx (ifosfamide-etoposide-oxaliplatin) salvage regimen in terms of response rate, toxicity and stem-cell mobilization. Thirty-four patients with relapsed/refractory HL after anthracycline-containing chemotherapy prospectively received IVOx, consisting of ifosfamide (1500 mg/m(2)  days 1-3), etoposide (150 mg/m(2)  days 1-3) and oxaliplatin (130 mg/m(2)  day 1). Patients <65 years old received high-dose therapy followed by autologous stem-cell transplantation (HDT-ASCT). Response was assessed by computed and positron-emission tomographies. Overall and complete response rates were 76% and 32%, respectively, after 2 cycles. Three episodes of febrile neutropenia occurred, and three patients required dose-reductions. Twenty-six patients underwent HDT-ASCT. With median follow-up at 5 years, the 5-year overall and event-free survival rates were 74% and 63%, respectively. IVOx is a well-tolerated outpatient regimen for relapsed HL, that does not hamper stem-cell mobilization, achieves good response rates and compares favourably with previously published salvage regimens.
authors.affiliation: Department of Haemato-Oncology, Saint-Louis Hospital, 1 avenue Claude-Vellefaux, Paris Cedex 10, France.
authors.forename: David
authors.initials: D
authors.lastname: Sibon
authors.forename: Marjane
authors.initials: M
authors.lastname: Ertault
authors.forename: Chadi
authors.initials: C
authors.lastname: Al Nawakil
authors.forename: Cédric
authors.initials: C
authors.lastname: de Bazelaire
authors.forename: Patricia
authors.initials: P
authors.lastname: Franchi
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Eric
authors.initials: E
authors.lastname: de Kerviler
authors.forename: Nathalie
authors.initials: N
authors.lastname: Beranger
authors.forename: Catherine
authors.initials: C
authors.lastname: Thieblemont
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D000077150:Oxaliplatin; D011446:Prospective Studies; D012008:Recurrence; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D001761:Bleomycin; D015251:Epirubicin; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D007069:Ifosfamide